Question

Mr. D Mr. D is a 90-year-old man who was admitted to the hospital with complaints of nausea, vomiting, left arm pain, and chest pain. An electrocardiogram (ECG) is performed, and he is diagnosed as having a myocardial infarction. Mr. D has a long history of comorbidities including hypertension, diabetes, and congestive heart failure (CHF). With this in mind, the physician asks Mr. D if he wants life-sustaining measures taken (e.g., CPR, mechanical ventilation, etc.) should he experience cardiopulmonary arrest. Mr. D tells the physician that he wants all measures taken to save his life.

Imagine that you are the nurse assigned to provide care to Mr. D, and address the following:

1. Considering Mr. D's advanced age, what are the benefits/risks associated with providing life-sustaining measures?
2. What factors should you consider based on the Mr. D's age and health history?
3. If Mr. D were your family member, how would you respond to his decision?

Answer 1

It is duty of the medical practitioner to save patients life in all possible circumstances.

In geriatric patient the drug action may be altered in some conditions. The patients response to the therapy is also decreased. By considering in his age and his past medical history it is clear that patient is in critical condition. If the patient has ability to tolerate the therapy then the physician may take all the life sustaining measures including mechanical ventilation. The benefits include increasing life span, providing quality of life, relieving symptoms of chest pain, left arm pain. Etc. The risks include hospital acquired infections, diffulty in taking food, depending on others, difficulty in breathing, some times it may cause total organ damage etc.

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Based on his and medical history the patient should be treated with utmost care. We should monitor his pulse, BP, GRBS, temp, spo2 level regularly. If any deviations are observed in these values then immediately consult respective physician. Also regularly observe ecg findings, ESR level. And also perform renal examination. If any side effects appeaeed then immediately report it to the physician.

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As a family member i respect Mr.D's opinion. I wish and request doctor to perform all the life sustaining measures. I want to increase his life span and be on his side forever.